CMS’ Jeneen Iwugo on agentic AI for fraud prevention

Jeneen Iwugo, Acting Director for the Center for Program Integrity at CMS, discusses the potential of agentic automation to streamline decision-making processes, particularly in handling claims and detecting fraud. Iwugo highlights ongoing pilots to optimize automation, emphasizing the goal of saving time and money by expediting actions. She notes that her agency reviews 4 to 5 million claims daily and prioritizes automation for high-risk providers, having suspended nearly $6 billion in fraud last year. Iwugo also underscores the significant untapped potential for AI and agentic AI to combat $100 billion in annual healthcare fraud, aiming to improve efficiency and save taxpayer dollars.